Effect on renal function of an iso-osmolar contrast agent in patients with monoclonal gammopathies

Preda, Lorenzo; Agazzi, Alberto; Raimondi, Sara; Lanfranchi, Carla Federica; Passerini, Rita; Calvetta, Albania; Martinelli, Giovanni; Bellomi, Massimo

doi:10.1007/s00330-010-1908-2

Cited by 12 publications

(12 citation statements)

References 29 publications

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“…18 This may be attributed to factors associated with cardiac angiography but not with peripheral aministration of contrast agents. Preda et al studied the effect of an iso-osmolar contrast agent on renal function in patients with monoclonal gammopathies and in patients with oncological disease 19 and found no statistically significant difference in serum creatinine, creatinine clearance and urinary NGAL levels 2 h after the procedure compared to baseline. On the other hand, a review showed the paucity of controlled clinical studies that demonstrate renal damage caused by intravenous contrast agents.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Magnetic Resonance Imaging and Computerized Tomography on Urinary Neutrophil Gelatinase Associated Lipocalin Levels

Özelsancak¹,

Torun²,

Zümrütdal³

et al. 2013

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Urinary neutrophil gelatinase associated lipocalin (NGAL) is among novel markers assessed for early diagnosis of acute kidney injury. The effect of gadolinium-based contrast media on urinary NGAL concentrations has not been studied before. The aim of our study was to compare the effect of iodinated contrast agents and gadolinium-based contrast media on renal function and on urinary NGAL levels in patients with normal renal function. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : The study group consisted of 40 patients. They were selected among patients who would undergo computerized tomography (CT) (n=20) or magnetic resonance imaging (MRI) (n = 20) scan. Patients with diabetes, malignancy or infection were excluded. Blood samples were drawn before, and 2 and 48 h after the procedure. Urine samples were collected before and 2 h after the procedure for NGAL measurements. Levels of urinary NGAL and blood creatinine before and after the procedure were compared. R Re es su ul lt ts s: : Urinary NGAL levels did not significantly change 2 h after the procedure compared to baseline value at CT [29 (4.1 -499) vs. 26.7 (1 -113) ng/ml, p=0.100] and at vs. 15.7 (3.5-112) ng/ml, p=0.313]. Although creatinine levels at 48 h were higher compared to baseline levels, they did not increase up to 50% in the CT group. The serum creatinine did not change at any time point in the MRI group. C Co on nc cl lu us si io on n: : Gadolinium or iodinated contrast agents did not significantly change urinary NGAL levels when used intravenously in patients with normal renal function.K Ke ey y W Wo or rd ds s: : Acute kidney injury; tomography, X-ray computed; magnetic resonance imaging; LCN2 protein, human Ö ÖZ ZE ET T A Am ma aç ç: : İdrarda nötrofil jelatinaz ile ilişkili lipokalin (NJİL), akut böbrek hasarının erken tanısı için üzerinde çalışılan göstergelerden biridir. Gadolinum içeren kontrast maddelerin idrar NJİL dü-zeyleri üzerindeki etkisi daha önce değerlendirilmemiştir. Çalışmamızın amacı, böbrek fonksiyonları normal olan hastalarda iyotlu kontrast maddelerle, gadolinum içeren kontrast maddelerin böbrek fonksiyonları ve idrar nötrofil jelatinaz ile ilişkili lipokalin düzeyleri üzerindeki etkilerini karşılaştırmaktır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Çalışma grubuna 40 hasta alındı. Hastalar bilgisayarlı tomografi (n=20) ve magnetik rezonans görüntüleme (n=20) uygulanacak hastalar arasından seçildi. Malinite, diyabet veya enfeksiyonu olan hastalar çalışmaya alınmadı. Kan örnekleri işlemden önce ve işlemden 2 ve 48 saat sonra alındı. İdrar örnekleri ise işlemden önce ve 2 saat sonra toplandı. İşlemden önce ve sonra idrar NJİL ve kan kreatinin düzeyleri karşılaştırıldı. B Bu ul lg gu ul la ar r: : Gerek bilgisayarlı tomografide [sırasıyla 29 (4,1 -499) ile 26,7 (1 -113) ng/ml, p=0,100], gerekse manyetik rezonans görüntülemede [sırasıyla 16 (6,7 -169) ile 15,7 (3,5-112) ng/ml, p=0,313] idrar NJİL düzeyleri, işlemlerden 2 saat sonra, bazal değer...

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Section: Discussionmentioning

confidence: 99%

The Effect of Magnetic Resonance Imaging and Computerized Tomography on Urinary Neutrophil Gelatinase Associated Lipocalin Levels

Özelsancak¹,

Torun²,

Zümrütdal³

et al. 2013

Turkiye Klinikleri J Med Sci

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“…Other potential clinical risk factors include hypertension, congestive heart failure, use of diuretics or NSAIDs, advanced age, hyperuricemia, and the dose of contrast administered [6••, 16]. Multiple myeloma and other monoclonal gammopathies are a risk factor with the use of HOCM [6••], but have not been linked to the newer lower-osmolality iodinated agents [21]. A second contrast-enhanced study within a short time interval from the first study may be associated with additional risk of CIN [22].…”

Section: Iodinated Contrast Agents and Contrast-induced Nephropathymentioning

confidence: 99%

Renal Imaging in Patients with Renal Impairment

2010

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In patients with renal impairment, the incremental benefits from administration of contrast media for imaging studies need to be carefully assessed relative to the potential increased risks of worsening renal dysfunction and systemic adverse effects. This review provides an overview of risk and benefits of iodinated and gadolinium-based contrast agents; examines their relationships to contrast-induced nephropathy (CIN) and nephrogenic systemic fibrosis (NSF), respectively; and discusses various clinical strategies to minimize the risk of CIN and NSF. Specifically, renal imaging strategies aimed to minimize the adverse effects of contrast media as well as alternatives to iodinated and gadolinium-based contrast-enhanced renal imaging are proposed with emphasis on non-contrast-enhanced magnetic resonance imaging.

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“…48,49,57 Nephropathy or Nephrotoxicity Throughout the literature, patient NGAL level has been shown to be an early marker of nephropathy/nephrotoxicity in a wide spectrum of clinical conditions, including renal tubular disease, 23,65,101 systemic lupus erythematosus, 94,96 acute renal impairment, 97 CKD, 32,53,95,100 HIV-associated nephropathy, 27 sickle cell nephropathy, 102 kidney cancer, 93 and CIN. 6,22,56,59,62,138,174,175 Contrast-induced nephropathy, often defined as an increase in patient serum creatinine level by 25% to 50% above baseline and generally occurring within the first 24 hours after contrast exposure (in the absence of other causes), has become the third leading cause of nosocomial AKI. 176 The reported incidence of CIN ranges from 0 to 50%, depending on the absence or presence of risk factors.…”

Section: Cardiac Surgerymentioning

confidence: 99%

“…179 As the utility of patient NGAL level has been established in detecting AKI, it has also been investigated to determine its usefulness as an early marker of AKI associated with CIN. 62,138,174,175 Patient NGAL level has been investigated to determine its role as a potential indicator of nephropathy or nephrotoxicity. 22,56, 59 We identified 26 clinical trials meeting our inclusion criteria that investigated the role of NGAL level in nephropathy or nephrotoxicity.…”

Section: Cardiac Surgerymentioning

confidence: 99%

Neutrophil Gelatinase Associated Lipocalin in Acute Kidney Injury

Peacock

Maisel

Kim

et al. 2013

Postgraduate Medicine

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Based on the evidence reviewed, it is clear that patient NGAL level is an appropriate, sensitive, and specific early biomarker of AKI caused by a variety of different etiologies. It is advised that a multidisciplinary group of experts come together to make recommendations and propose a consensus of clinical procedures to advance the most efficacious NGAL monitoring protocol for early detection and treatment of patients with AKI.

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Effect on renal function of an iso-osmolar contrast agent in patients with monoclonal gammopathies

Abstract: The use of iodixanol appears to be safe in patients with monoclonal gammopathies and an eGFR≥ 60 ml/min/1.73 mq.

Cited by 12 publications

References 29 publications

The Effect of Magnetic Resonance Imaging and Computerized Tomography on Urinary Neutrophil Gelatinase Associated Lipocalin Levels

The Effect of Magnetic Resonance Imaging and Computerized Tomography on Urinary Neutrophil Gelatinase Associated Lipocalin Levels

Renal Imaging in Patients with Renal Impairment

Neutrophil Gelatinase Associated Lipocalin in Acute Kidney Injury

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